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The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review
Madelon L J M van Hees, Thomas Rotter, Tim Ellermann, Silvia M A A Evers
BMC Psychiatry , 2013, DOI: 10.1186/1471-244x-13-22
Abstract: Systematic searches of PubMed and PsycINFO studies between January 1970 and August 2012 were performed to identify (C-)RCTs, in which MDD was a primary diagnosis in adult outpatients receiving individual IPT as a monotherapy compared to other forms of psychotherapy and/or pharmacotherapy.1233 patients were included in eight eligible studies, out of which 854 completed treatment in outpatient facilities. IPT combined with nefazodone improved depressive symptoms significantly better than sole nefazodone, while undefined pharmacotherapy combined with clinical management improved symptoms better than sole IPT. IPT or imipramine hydrochloride with clinical management showed a better outcome than placebo with clinical management. Depressive symptoms were reduced more in CBASP (cognitive behavioral analysis system of psychotherapy) patients in comparison with IPT patients, while IPT reduced symptoms better than usual care and wait list condition.The differences between treatment effects are very small and often they are not significant. Psychotherapeutic treatments such as IPT and CBT, and/or pharmacotherapy are recommended as first-line treatments for depressed adult outpatients, without favoring one of them, although the individual preferences of patients should be taken into consideration in choosing a treatment.Major depressive disorder (MDD) is a mental disorder characterized by a depressed mood, diminished interest or pleasure, sleeping problems and tiredness, and negative thoughts [1]. The mean one-year-prevalence of depression in European inhabitants between 18 and 65?years old is 6.9% [2], and 16.2-16.6% of US adults develop a major depressive disorder [3,4]. Furthermore, depression causes a high burden worldwide, taking fourth place in a ranking of leading contributors to the burden of diseases in 2000. In 2020, it is estimated that depression will take second place in the ranking for all ages and sexes [5]. Moreover, depression is the leading cause of years of l
Methods for the evaluation of hospital cooperation activities (Systematic review protocol)
Thomas Rotter, Daniela Popa, Beatrice Riley, Tim Ellermann, Ulrike Ryll, Genc Burazeri, Piet Daemen, Guy Peeters, Helmut Brand
Systematic Reviews , 2012, DOI: 10.1186/2046-4053-1-11
Abstract: This is a protocol for a systematic review, following the Cochrane EPOC methodology. The review aims to document, catalogue and synthesize the existing literature on the reported methods for the evaluation of hospital cooperation activities as well as methods of hospital cooperation. We will search the Database of Abstracts of Reviews of Effectiveness, the Effective Practice and Organisation of Care Register, the Cochrane Central Register of Controlled Trials and bibliographic databases including PubMed (via NLM), Web of Science, NHS EED, Business Source Premier (via EBSCO) and Global Health for publications that report on methods for evaluating hospital cooperatives, strategic partnerships, mergers, alliances, networks and related activities and methods used for such partnerships. The method proposed by the Cochrane EPOC group regarding randomized study designs, controlled clinical trials, controlled before and after studies, and interrupted time series will be followed. In addition, we will also include cohort, case-control studies, and relevant non-comparative publications such as case reports. We will categorize and analyze the review findings according to the study design employed, the study quality (low versus high quality studies) and the method reported in the primary studies. We will present the results of studies in tabular form.Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin hospital cooperation activities as defined in this protocol. As a result, the review will provide an evidence base for partnerships, alliances or other fields of cooperation in a hospital setting. PROSPERO registration number: CRD42011001579Research into the ways hospital services are managed, into understanding hospital cooperatives, hospital partnerships, or for instance hospital mergers has, for long, been neglected [1-3]. This is astonishing since hospitals account for 40% to 60% of the health expenditure in OECD countries [4]. From
Macrophages and cytokines in the early defence against herpes simplex virus
Svend Ellermann-Eriksen
Virology Journal , 2005, DOI: 10.1186/1743-422x-2-59
Abstract: Normally, the primary HSV infection is asymptomatic, and a crucial element in the early restriction of virus replication and thus avoidance of symptoms from the infection is the concerted action of different arms of the innate immune response. An early and light struggle inhibiting some HSV replication will spare the host from the real war against huge amounts of virus later in infection. As far as such a war will jeopardize the life of the host, it will be in both interests, including the virus, to settle the conflict amicably. Some important weapons of the unspecific defence and the early strikes and beginning battle during the first days of a HSV infection are discussed in this review.Generally, macrophages are orchestrating a multitude of anti-herpetic actions during the first hours of the attack. In a first wave of responses, cytokines, primarily type I interferons (IFN) and tumour necrosis factor are produced and exert a direct antiviral effect and activate the macrophages themselves. In the next wave, interleukin (IL)-12 together with the above and other cytokines induce production of IFN-γ in mainly NK cells. Many positive feed-back mechanisms and synergistic interactions intensify these systems and give rise to heavy antiviral weapons such as reactive oxygen species and nitric oxide. This results in the generation of an alliance against the viral enemy.However, these heavy weapons have to be controlled to avoid too much harm to the host. By IL-4 and others, these reactions are hampered, but they are still allowed in foci of HSV replication, thus focusing the activity to only relevant sites. So, no hero does it alone. Rather, an alliance of cytokines, macrophages and other cells seems to play a central role. Implications of this for future treatment modalities are shortly considered.Virus-host interactions are crucial for the outcome of infections. Several strategies have been utilized by viruses to overcome the host defence. For the virus to be successful,
Production of exotic atoms at energies available at the CERN Large Hadron Collider
C. A. Bertulani,M. Ellermann
Physics , 2010, DOI: 10.1103/PhysRevC.81.044910
Abstract: We study in details the space-time dependence of the production of muonic, pionic, and other exotic atoms by the coherent photon exchange between nuclei at the Large Hadron Collider at CERN. We show that a multipole expansion of the electromagnetic interaction yields an useful insight of the bound-free production mechanism which has not been explored in the literature. Predictions for the spatial, temporal, and angular distribution, as well as the total cross sections, for the production of exotic atoms are also included.
Production of exotic atoms at the CERN Large Hadron Collider (LHC)
C. A. Bertulani,M. Ellermann
Physics , 2010, DOI: 10.1103/PhysRevC.81.04491
Abstract: We study in details the space-time dependence of the production of muonic, pionic, and other exotic atoms by the coherent photon exchange between nuclei at the Large Hadron Collider (LHC) at CERN. We show that a multipole expansion of the electromagnetic interaction yields an useful insight of the bound-free production mechanism which has not been explored in the literature. Predictions for the spatial, temporal, and angular distribution, as well as the total cross sections, for the production of exotic atoms are also included.
A Study on Configuration and Integration of Sub-Systems to System-of-Systems with Rule Verification  [PDF]
Tim Warnecke
Engineering (ENG) , 2015, DOI: 10.4236/eng.2015.710056
Abstract: Increasing complexity of today’s software systems is one of the major challenges software engineers have to face. This is aggravated by the fact that formerly isolated systems have to be interconnected to more complex systems, called System-of-Systems (SoS). Those systems are in charge to provide more functionality to the user than all of their independent sub-systems could do. Reducing the complexity of such systems is one goal of the software engineering paradigm called component-based software engineering (CBSE). CBSE enables the developers to treat individual sub-systems as components which interact via interfaces with a simulated environment. Thus those components can be developed and implemented independently from other components. After the implementation a system integrator is able to interconnect the components to a SoS. Despite this much-used approach it is possible to show that constraints, which are valid in an isolated sub-system, are broken after this system is integrated into a SoS. To emphasize this issue we developed a technique based on interconnected timed automata for modelling sub-systems and System-of-Systems in the model checking tool UPPAAL. The presented modelling technique allows it to verify the correctness of single sub-systems as well as the resulting SoS. Additionally we developed a tool which abstracts the complicated timed automata to an easy to read component based language with the goal to help system integrators building and verifying complex SoS.
Apparent Temperature and Cause-Specific Emergency Hospital Admissions in Greater Copenhagen, Denmark
Janine Wichmann, Zorana Andersen, Matthias Ketzel, Thomas Ellermann, Steffen Loft
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0022904
Abstract: One of the key climate change factors, temperature, has potentially grave implications for human health. We report the first attempt to investigate the association between the daily 3-hour maximum apparent temperature (Tappmax) and respiratory (RD), cardiovascular (CVD), and cerebrovascular (CBD) emergency hospital admissions in Copenhagen, controlling for air pollution. The study period covered 1 January 2002?31 December 2006, stratified in warm and cold periods. A case-crossover design was applied. Susceptibility (effect modification) by age, sex, and socio-economic status was investigated. For an IQR (8°C) increase in the 5-day cumulative average of Tappmax, a 7% (95% CI: 1%, 13%) increase in the RD admission rate was observed in the warm period whereas an inverse association was found with CVD (?8%, 95% CI: ?13%, ?4%), and none with CBD. There was no association between the 5-day cumulative average of Tappmax during the cold period and any of the cause-specific admissions, except in some susceptible groups: a negative association for RD in the oldest age group and a positive association for CVD in men and the second highest SES group. In conclusion, an increase in Tappmax is associated with a slight increase in RD and decrease in CVD admissions during the warmer months.
Apparent temperature and acute myocardial infarction hospital admissions in Copenhagen, Denmark: a case-crossover study
Janine Wichmann, Matthias Ketzel, Thomas Ellermann, Steffen Loft
Environmental Health , 2012, DOI: 10.1186/1476-069x-11-19
Abstract: This is the first study of the association between the daily 3-hour maximum apparent temperature (Tappmax) and AMI hospital admissions in Copenhagen. The study period covered 1 January 1999-31 December 2006, stratified in warm (April - September) and cold (October - March) periods. A case-crossover epidemiology study design was applied. Models were adjusted for public holidays and influenza, confounding by PM10, NO2 and CO was investigated, the lag and non-linear effects of Tappmax was examined, effect modification by age, sex and SES was explored, and the results of the case-crossover models were compared to those of the generalised additive Poisson time-series and generalised estimating equation models.14 456 AMI hospital admissions (12 995 people) occurred during the study period. For an inter-quartile range (6 or 7°C) increase in the 5-day cumulative average of Tappmax, a 4% (95% CI:-2%; 10%) and 9% (95% CI: 3%; 14%) decrease in the AMI admission rate was observed in the warm and cold periods, respectively. The 19-65 year old group, men and highest SES group seemed to be more susceptible in the cold period.An increase in Tappmax is associated with a decrease in AMI admissions during the colder months.The influence of certain weather types (heat waves and air mass types), specific weather parameters, and also of the atmospheric environment in general, on human health, particularly all-cause mortality, has been studied extensively [1-4]. It is likely that the overall effect of temperature strongly depends on the general climate of the area, cause and type of health outcome (death or hospital admission), population characteristics (age, sex, socio-economic status (SES)), and the efficiency of the health system. Some of the effects of temperature may occur through pathways involving air pollution, but the effects of temperature on health, independent of air pollution, is also of interest.The influence of temperature on morbidity and mortality from acute myocardial i
Population-based study of diagnostic assays for Borrelia infection: comparison of purified flagella antigen assay (Ideia?, Dako Cytomation) and recombinant antigen assay (Liaison?, DiaSorin)
Eskild Petersen, Martin Tolstrup, Francesco Capuano, Svend Ellermann-Eriksen
BMC Clinical Pathology , 2008, DOI: 10.1186/1472-6890-8-4
Abstract: We compared the use of recombinant antigens (LIAISON? DiaSorin, Saluggia, Italy) and purified flagella antigen (IDEIA? Borrelia, DakoCytomation, Glostrup, Denmark) in the assay for Borrelia-specific IgM and IgG-antibodies. The assays were tested on an unselected population of serum samples submitted from general practice. A total of 357 consecutive samples for analysis of Borrelia IgM and IgG antibodies. Furthermore, we analysed 540 samples for Borrelia-specific IgM or IgG antibodies first by the IDEIA? and, if they were positive, the samples were further analysed using the LIAISON? assay. To verify the correctness of the patient's serological status, discrepant samples were analysed by line blots (EcoLine, Virotech).In the consecutive series of 357 samples, the IgM assays detected 308 negative and 3 positive samples with concordant results. Compared with the line blot, the IDEIA? system produced 21 false-positive IgM results, whereas the LIAISON? system produced only one false-positive IgM result. The IgG assays showed 1 positive and 328 negative concordant results. The LIAISON? system produced 9 true IgG-positive samples that were not detected by the IDEIA? system, but the former produced 4 positive IgG results that were negative by line blot.Diagnostic assays based on flagella antigen seem to show more false-positive IgM and false-negative IgG results than assays based on recombinant antigens. The latter may reduce the number of presumably false-positive IgM results and identify more IgG-positive subjects, but this system also produces more false-positive IgG results.Infection with Borrelia spp. is the most common vector borne infection in Europe with an estimated more than 60,000 symptomatic cases annually and a reported incidence from Germany of about 1 per 1,000 population [1]. Infection may result in a variety on clinical symptoms, including neuroborreliosis with cranial nerve paresis and radicular pain. Borrelia infections in humans are caused by B. afzelli,
Particle number, particle mass and NOx emission factors at a highway and an urban street in Copenhagen
F. Wang,M. Ketzel,T. Ellermann,P. W?hlin
Atmospheric Chemistry and Physics Discussions , 2009,
Abstract: This paper presents measurements of traffic-generated gas and particle pollution at two sites, one near a major highway and one near a busy urban street in Copenhagen, Denmark. Both sites were equipped for a 4-week period with a set of two measurement stations, one close to the kerbside and one background station. Measurements were carried out from March to April 2008, investigating NOx concentrations, submicrometer particle number size distribution (size range 10–700 nm), particle mass (PM2.5, PM10), and meteorological parameters. In this study we further estimate the emission factors for NOx, particle number and particle mass using measured traffic volume and dilution rate calculated by the Operational Street Pollution Model (WinOSPM). The mean concentrations of most of the measured pollutants are similar for the highway and the urban kerbside stations due to similar traffic density. The average concentrations of NOx are 142 μg m and 136 μg m for the highway and the urban kerbside stations, respectively. These values are about 5 times higher compared to the corresponding background values. The average particle number concentration is 24 860 particles cm 3 and 27 100 particles cm 3 for the highway and the urban kerbside stations, respectively, and these values exceed those measured at the background stations by a factor of 3 to 5. The temporal variation of the traffic contribution (difference of kerbside and background concentrations) is analysed for NOx, particle number and mass, and it follows the traffic pattern at the urban and the highway sites. Emission factors for particle number are found to be quite similar at both sites, (215.4±5.3) 1012 particles veh 1 km 1 for the highway and (187.1±3.1)1012 particles veh 1 km for the urban site. Heavy duty vehicles (HDVs) are found to emit about 20 times more particles than light duty vehicles (LDVs), which is in good agreement with other published studies. Emission factors are also determined for individual particle modes identified in the size spectra. Average fleet emission factors for PM2.5 at the highway and the urban site are 29 mg km 1 and 46 mg km 1, respectively. The estimated particle number and size spectra emission factors will provide valuable input for air quality and particle dispersion modelling near highways and in urban areas.
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